Ultrasound-guided In-plane vs Out-of-plane Approach for Radial Arterial Cannulation after Transradial Cardiac Catheterization: A Randomized Prospective Study

rate of complications and an increased first-pass success rate.Two frequently used US-guided RA cannulation procedures are the short-axis out-of-plane (SA-OOP) and long-axis in-plane (LA-IP) approaches.The research currently in publication, however, is divided about the value of these methods for cannulating the radial arteries of both adults and children. IntroductIonIn clinical settings, such as the operating room, intensive care unit, and emergency department, arterial cannulation is the standard procedure for arterial blood sampling and continuous blood pressure monitoring.In major surgical and critical care situations, the radial artery (RA) physical accessibility, dual arterial supply of the hand, and low complication rate make it a preferred option for invasive blood pressure monitoring and arterial sampling. 1,2The use of RA cannulation for coronary angiography and intervention is well acknowledged. 3On the contrary, failure to cannulate the RA is highly probable if it has been cannulated for a previous procedure. 4natomical knowledge and pulse palpation have always been the main methods of guidance for RA cannulation.In individuals with arrhythmias, obesity, low perfusion pressure, or those who have failed palpation methods for cannulation, ultrasound (US) can enhance arterial access.However, when patients have undergone transradial catheterization for coronary angiography, the palpatory method for cannulation may be unsuccessful.This may result in multiple attempts, patient discomfort, and inability to cannulate the artery.Before or during blood vascular cannulation, US imaging has increased first-pass success and decreased the risk of complications.Numerous studies have linked the US to a lower 1,